Florida Claims Adjuster Exam, 6 -20 All Lines Adjuster - Florida - Review Correctly Answered Latest 2023 Peril - CORRECT ANSWER Something that causes a loss. Hazard - CORRECT ANSWER Something that increases the probability that a loss will occur. Warranty - CORRECT ANSWER A policy condition, either based on information in the insureds applicati on or inserted by the insurer. It is a guarantee of a fact. Misrepresentation - CORRECT ANSWER An untrue statement by the insured, made in an application for insurance but which does not become a part of the policy. Concealment - CORRECT ANSWER T he failure of the insured to reveal relevant facts known to the insured in applying for insurance. Abandonment - CORRECT ANSWER Property insurance policies usually contain an abandonment clause, stating the insured cannot dump damaged property on the insurer and demand its full value. Severability - CORRECT ANSWER The insurance applies separately to each insured as if other insureds did not exist. Proximate Cause - CORRECT ANSWER The cause having the most significant impact in bringing about the loss under a first -party property insurance policy, when two or more independent perils operate at the same time (i.e., concurrently) to produce a loss. Courts employ a set of rules to resolve causation disputes when a property policy states that it co vers or excludes losses "caused by" a peril and there is more than one peril at work in a fact pattern. Under common law, whether the policy provides coverage depends on which peril is chosen as the proximate cause. Direct Loss - CORRECT ANSWER Physic al harm to tangible property. Indirect Loss - CORRECT ANSWER Economic loss which flows as a result of direct loss. Actual Cash Value(ACV) - CORRECT ANSWER Replacement Cost minus Depreciation Coinsurance - CORRECT ANSWER The amount, generally expressed as a fixed percentage, an insured must pay against a claim after the deductible is satisfied. It's ultimately a way for the insured and insurer to share responsibility for the risk. It can also help reduce the cost of the insurance policy premiu m. Coinsurance can be written on an 80/20, 90/100, or 100% rule. Personal Contract - CORRECT ANSWER Policies cover people who own and operate things, such as automobiles. Conditional Contract - CORRECT ANSWER Also called a hypothetical contract, is a contract agreement that only requires performance once the delineated conditions are met. This legal agreement requires prior performance of another agreement or clause in order to be enforceable. If the other agreement or condition is performed, then the conditional contract is enforceable and the parties are bound to carry out the terms of the contract. Contract of Indemnity - CORRECT ANSWER Principle of insurance that provides that when a loss occurs, the insured should be restored to the approximate financial condition he/she occupied before the loss occurred, no better or no worse. Insurable Interest - CORRECT ANSWER the reasonable con cern of a person to obtain insurance for any individual or property against unforeseen events such as death, losses, etc. Florida Claims Adjuster Exam, 6 -20 All Lines Adjuster - Florida - Review Correctly Answered Latest 2023 Waiver - CORRECT ANSWER 1.) Implied voluntary relinquishment, abandoning a legal advantage, need, claim or right. 2.) Agreement or added clause of a policy that excludes some losses or limits the sum of a claim, or extends coverage to add items not in a normal policy. Express Waiver - CORRECT ANSWER Occurs when the insurer or its representative knowingly gives up a known right under the insurance contract. Implied Waiver - CORRECT ANSWER A waiver that is assumed to be in effect from a person's behavior and shows he is waiving a right. Damages - CORRECT ANSWER Monetary compensation that is awarded by a court in a civil action to an individual who has been injured through the wrongful conduct of another party. Subrogation - CORRECT ANSWER When an insured has a right to collect damages from another party, but instead elects to claim the damages under his insurance po licy, his rights against the other party are transferred to the insurer. Changes - CORRECT ANSWER All policies provide that any changes to the policy be made by the insurer, in writing. Policy Period - CORRECT ANSWER The condition states that cov erage applies only to losses or occurrences that take place during the policy period. (Prior to the stated date and time of termination). Policy Territory - CORRECT ANSWER Condition limiting coverage to occurrences or losses that take place only withi n a stated geographical region. Other Insurance - CORRECT ANSWER The principle of indemnity dictates against duplicate recovery for the same loss. Cancellation - CORRECT ANSWER The insured may cancel at any time, for any reason, without advance n otice. If the conpany wishes to cancel, it must provide some degree of advance notice so the insured will have time to replace the coverage. Appraisal - CORRECT ANSWER A written contract of or written agreement for or effecting insurance, or the certi ficate thereof, by whatever name called, and includes all clauses, riders, endorsements and papers which are a part thereof. Insurance - CORRECT ANSWER Is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a d eterminable benefit upon determinable contingencies. Binder - CORRECT ANSWER Acts as a temporary contract until the policy is issued. How many days should an insurer give for prior notice of cancellation of a binder? - CORRECT ANSWER 5 days. Prop erty Insurance - CORRECT ANSWER Any insurance wherein payment by the insurer will be paid directly to the insured or other specifically named interests. Liability Insurance - CORRECT ANSWER Payment will be on behalf of the insured to another, bas ed upon the insureds liability to the recipient. Simply stated, Liability is "Negligence of the Insured". Loss Payee Clause - CORRECT ANSWER A Clause in a contract of insurance that provides, in the event of payment being made under the policy in rela tion to the insured risk, that payment will be made to a 3rd party rather than to the insured beneficiary of the policy. Florida Claims Adjuster Exam, 6 -20 All Lines Adjuster - Florida - Review Correctly Answered Latest 2023 Mortgage Clause - CORRECT ANSWER A property insurance provision granting special protection for the interest of a mortgagee named in the policy, in effect setting up a separate content between the insurer and the mortgagee. Other Structures - CORRECT ANSWER Covers items that are not permanently attached to the main dwelling, such as a shed, fence, etc. Commercial Inland Marine - CORRECT ANSWER Helps identify the kinds of risk which are eligible for either ocean or inland Marine insurance. Building Ordinance Coverage - CORRECT ANSWER This endorsement covers the insured for enforcement of laws which require demolition of undamaged portions of buildings. Umbrella Policy - CORRECT ANSWER Covers a much higher limit and goes above and beyond claims directly relating to your home and auto, it provides your assets from an unforeseen event, such as a tragic accident in which you are held responsible for damages or bodily injuries. Known Loss - CORRECT ANSWER Prevents an insured from coverage if the insured knew the loss was probable at the time of the insurance contract. Value Reporting - CORRECT ANSWER The limit of coverage is set at an amount somewhat higher than expected peak values. Commercial Property Insurance - CORRECT ANSWER Covers direct and indirect losses related to properties other than one to four family dwellings and farm properties. Employee Theft - CORRECT ANSWER Provides coverage for loss of or damage to money, securities, and other property resulting from theft committed by an employee. Theft is defined as the unlawful taking of money, securities or other property to the deprivation of the insured. Bid - CORRECT ANSWER Aggreement to fulfill a contractual obligation used frequently in construction and supplying goods. Health Maintenance Organization (HMO) - CORRECT ANSWER Provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. Preferred Provider Organization (PPO) - CORRECT ANSWER A selected group of hospital's and medical practitioners in a given area who have joined together in an effort to reduce medical costs. Estoppel - CORRECT ANSWER Is an equitable principle to the effect that if one intentionally or unintentionally creates the impression that a certain fact exists, and an innocent party relies on th at impression and is damaged as a result, the guilty party may be legally prohibited(estopped) from asserting that the fact does not exist. Salvage - CORRECT ANSWER Motor vehicle or mobile home is a total loss. Junk - CORRECT ANSWER Any material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal. Fiduciary Agent - CORRECT ANSWER Agent for a principal/Client. The legal or special relationship of trust, confidence, or responsibility between 2 or more parties. Florida Claims Adjuster Exam, 6 -20 All Lines Adjuster - Florida - Review Correctly Answered Latest 2023 Domestic Insurer - CORRECT ANSWER Insurer is one formed under the laws of its this state. Foreign I nsurer - CORRECT ANSWER Insurer is one formed under the laws of any state, district territory, or commonwealth of the United States other than this State. Alien Insurer - CORRECT ANSWER Insurer is an insurer other than a domestic or foreign insur er. Appointment - CORRECT ANSWER The authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf an insurer or employer. Derelict - CORRECT ANSWER Material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or component parts or both. Mechanical Breakdown Coverage - CORRECT ANSWER Covers repairs to mechanical parts of your vehicle that break. Even covers break in events not related to an accident. Sliding - CORRECT ANSWER Selling an item and stating that it is required by law. What is the Death Benefit amount f or PIP ? - CORRECT ANSWER $5,000 What is the amount for medical and disability benefits afforded by PIP ? - CORRECT ANSWER $10,000 Who is the Financial Responsibility Law administered by ? - CORRECT ANSWER The Department of Highway Safety an d Motor Vehicles. What are the Basic PIP Benefits ? - CORRECT ANSWER -Medical -80% of responsible expenses are paid for necessary medical, surgical, X -Ray and dental. -Work Loss -60% of any loss of gross income and loss of earning capacity reimbursed. -Replacement Services -100% for the cost of having household services performed by others. -Death -Effective 01/01/2013 the death benefit will be $5,000 in addition to the $10,000 in medical and disability benefits afforded by PIP. Company or Staff Adjuster - CORRECT ANSWER Are salaried employees under the supervision of the home, branch or regional claims department of insurers. Fee Adjusters - CORRECT ANSWER Offer their services on a fee -for-service basis. They represent many insurers. Bureau Adjus ter - CORRECT ANSWER Employee or agent of an adjustment bureau which serves multiple company clients such as the GAB Business Services, Inc and Underwriters Adjusting Company both national firms. Independent Adjuster - CORRECT ANSWER Are Self -Employed and are not affiliated with either insurers or bureaus. They serve as adjuster representatives of insurers, and their services are compensated on a fee -plus-expenses basis for each loss handled. Public Adjuster - CORRECT ANSWER Is a claims adjus ter who is an advocate for the policyholder in appraising and negotiating an insurance claim.
